Risk of Hypertrophic Scars from Earlobe Surgery?

I want an earlobe repair or reduction surgery. However, I have a hypertrophic scar on my shoulder for the past 3 years. I don't know how I got it. It's 1.5 cm long. No surgery or injury that I can remember. I am 30 years old. I am scared of keloid formation once I carry out an earlobe reduction surgery. How scared should I realistically be?

Doctor Answers 23

Poor scarring in earlobe surgery is uncommon

The skin and tissue quality of the earlobe is very different from that of your shoulder. Also, the stresses and pulling on the incision between the two areas are dramatically different. So while your shoulder scar, perhaps expectantly, became wide and hypertrophic such a result on your earlobe is very unlikely.  With the rare exception of treating true earlobe keloids, I have never seen a hypertrophic earlobe scar develop from either earlobe reduction or the repair of ear piercings or ear gauging reconstruction.

Indianapolis Plastic Surgeon
4.7 out of 5 stars 72 reviews

Earlobe scar hypertrophy

The shoulder is one of the worst areas of the body in terms of scarring; I would not extrapolate a poor shoulder scar to conclude that you will automatically scar badly on the earlobe.  Keloid formation is a different process from scar hypertrophy.  If you did not form keloids from the ear piercing or laceration, it is highly unlikely that you will form a keloid mass at the site of earlobe repair.  In terms of scar hypertrophy, this can be controlled by kenalog injection should it develop  but is uncommon in the earlobe.

Robert L. Kraft, MD, FACS
New York Plastic Surgeon
5.0 out of 5 stars 40 reviews

Earlobe surgery and scars

Hypertrophic scarring (thick wide scar) is different from keloids (scar mass that keeps growing well outside the boundaries of the scar).  If you have not had keloids develop in the ear area before from previous piercings, then it is unlikely that you would develop keloid in your ear now.

Thomas T. Le, MD
Baltimore Facial Plastic Surgeon
4.9 out of 5 stars 57 reviews

Keloids or Hypertrophic Scars after Earlobe Surgery

If you have earlobe piercings and do not have any hypertrophic scarring or keloids from that, there would seem to be a lower likelihood that you would form keloids after repair of your earlobes. However, you have a hypertrophic scar or keloid on your shoulder so that would suggest a propensity to forming hypertrophic scars or keloids. I have seen a number of keloids on the earlobes of people. Most of these are African-Americans, and most of these patients also had keloids on the jawline or chest or back or shoulders. The problem with keloids is that you cannot predict that a keloid will develop, and once you develop a keloid, you have to be very careful with further surgery to that keloid for fear of making it worse. Most of these people that I have seen with keloids on their ears developed keloids after ear piercing so the fact that you have piercings and no keloids would suggest that your likelihood of developing keloids is less. But unfortunately, there can't be any guarantees. Best to meet with a dermatologist to evaluate the scarring on your shoulder and discuss your options for your earlobes.

Andrew Kaufman, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 16 reviews

Earlobe repair

If you do not form keloids, then the risk is very low to have problems once the earlobe is repaired.  Good luck.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Hypertrophic keloid scars of the earlobe are Uncommon

While keloid scars can occur on earlobes, they are uncommon. 

Despite having a keloid scar on your shoulder, If you have already had your earlobes pierced and have no keloids there, then it is not likely that they would occur with repair of the earlobe holes and reduction of the earlobe.

However, there is no absolute certainty about scars.

Fredrick A. Valauri, MD
New York Plastic Surgeon

Risk of keloids with ear lobe surgery

If you have a tendency to make keloids and hypertrophic scars, especially unprovoked ones like you describe, you will have a tendency to form a keloid after ear lobe surgery. There is no way to predict or prevent keloid formation.

Once it starts, it may be minimized by intralesional injections of triamcinolone. But keloidal tissue can be aggressive and grow despite our best efforts to control it.

Please consider carefully whether you wish to take that risk.

Emily Altman, MD
Short Hills Dermatologic Surgeon
5.0 out of 5 stars 4 reviews

Should you worry about keloids with earlobe repair?

If your ears are pierced and you do not have any abnormal scarring of the earlobes, it is highly unlikely that earlobe repair or reduction will result in hypertrophic or keloid scarring.

If your ears are pierced,and you do have elevated scars, then you are at significant risk for unsatisfactory scarring with earlobe surgery.  If you choose to proceed with surgery, you may wish to have steroid injections performed before, during, and/or after the repair.

If yours have never been pierced, then your best gauge of how your earlobes will scar is the appearance of scars elsewhere on your body.  If you have a tendency toward hypertrophic scarring, you may want to consider a "test" incision along the back of the earlobe before undergoing earlobe reduction surgery.  This will give you a very good indication of how you will scar with the surgery.

Ronald Friedman, MD
Plano Plastic Surgeon
5.0 out of 5 stars 46 reviews

Keloid prevention

Keloids are a common occurance in the ear lobes  for some people. It is usually associated with  unsanitory earpiercing and subclinical infection and chronic inflammtion resulting from that. However ther are ways  to prevent recurrance of Keloid following  ear lob surgery. Using basic principles of plastic surgery in wound handling and repair, application of Bleomycin to the wound before closure, post operative Kenalog injection, applicationof silcone scar compression pad etc are known to prevent or control keloid formation. So instead being scared be optimistic about your procedure. 

Zain Kadri, MD
Los Angeles Facial Plastic Surgeon

Scarring After Earlobe Surgery Uncommon

Scarring after any earlobe repair is rather uncommon. The wounds are generally closed with very minimal tension. In addition, if you notice a hypertrophic scar or keloid forming, early intervention with steroid injections or other treatments can often prevent an undesireable result.

D.J. Verret, MD
Dallas Facial Plastic Surgeon
3.9 out of 5 stars 14 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.